17-040 Installation Agreement, 10110 Peninsula Avenue, APN 326-24-028•. RECORDING REQUESTED BY:
C ity of Cupe1iino
WHEN RECORDED, MAIL TO:
City C lerk's Office
City of Cupertino
103 00 Tone A venue
Cupertino, CA 95014-3255
NO FEE IN ACCORDANCE
WITH GOV. CODE 27383
23624472
Regina Alcomendras
Santa Clara County -Clerk-Recorder
04/13/2017 11:30 AM
Pages: 20
(SPACE ABOVE THIS LINE FOR RECORDER'S USE)
INSTALLATION AGREEMENT
10110 Peninsula A venue, Cupertino, CA
APN: 326-24-028
~, Original
D For Fast Endorsement
NO FEE"
City of Cupertino
CERTIFICATE OF ACCEPTANCE is here by given in order to comply with the
provisions of Section 27283 of the Government Code.
This is to certify that the interes t in real property conveyed by the deed or grant
dated March 30, 2017, from
10110 Peninsula Avenue, Cupertino, CA 95014
to the City of Cupertino, a governmental agency, is hereby accepted by order of the
Public Works Direc tor, and the grantee consents to recordation thereof by its duly
authorized officer.
Dated: April 7, 2017
By: @AA,~~
Lauren Sapudar
Senior Office Assistant
City of Cupertino
INSTALLATION AGREEMENT
(Cupertino Municipal Code Chapter 14.04)
10110 Peninsula Avenue, Cupertino, CA
APN: 326-24-028
This _I NSTALLATION AGREEMENT ("Agreement") is made and entered into this "i O day of
/11.,, .• ) ... ..-f/{._= , 20__L_l_, by and between the CITY OF CUPERTINO, a municipal corporation ' .
of the State of California, ("CITY"), and Doreen Rovetti ("DEVELOPER") for a single family residence
located at 10110 Peninsula Avenue, Cupertino CA.
RECITALS
1. DEVELOPER has presented to the City an application for a development entitlement
consisting of a single family residence (the "Development Entitlement") located at 10110
Peninsula Avenue, Cupertino CA (the "Property").
2. Chapter 14.04 of the Cupertino Municipal Code ("CMC") requires, as a condition
precedent to the erection, construction, addition, alteration or repair of any building or structure
in certain designated areas of the City with unimproved streets and for which a building permit is
required by the City, installation of certain types of public improvements and/or dedication where
deemed necessary by the City Engineer.
3. In consideration of City's approval of the Development Entitlement and pursuant to the
requirements of CMC Chapter 14.04, Developer desires to enter into this Agreement promising to
install and complete, at Developer's sole expense, all public improvement work required by the
City for the proposed development.
4 . Developer has prepared and City has approved plans and related specifications (the
"Improvement Plans") for construction , installation and completion of improvements. The
Improvement Plans titled Street Improvement Plans for 10110 Peninsula Avenue, prepared by Bay
Land Consulting, Land Surveyors/Civil Engineers, are hereby incorporated into this Agreement by
reference.
NOW, THEREFORE, in consideration of the approval by City of the Development
Entitlement, City and Developer agree as follows :
Page 1 of 11
1. DEVELOPER'S OBLIGATION TO INSTALL IMPROVEMENTS
a. Completion of Improvements. Developer, at its own expense , shall furnish, install, and
construct all improvements required by the City Engineer pursuant to Chapter 14.04 of the
Cupertino Municipal Code , or as amended, in a good and workmanlike manner and as shown on
the Improvement Plans as approved by the City Engineer of Cupertino and in accordance with
existing ordinances and resolutions of the CITY and other applicable laws. The decision of the City
Engineer shall be final as to whether any material or workmanship meets the plans, specifications,
and standards as set forth.
b . Compliance with applicable laws and rules . Developer shall complete the Work in
accordance with the most current Standard Specifications of the Department of Public Works,
California Department of Transportation, State of California, and in accordance with the
specifications of the Cupertino Sanitary District where applicable. Wherever the words "State " or
"California Division of Highways " are mentioned in the State Specifications, it shall be considered
as referring to the City of Cupertino; also wherever the "Director" or "Director of Public Works" is
mentioned, it shall be considered as referring to the City Engineer. In case of conflict between the
State Specifications and the specifications of the CITY, and/or the Cupertino Sanitary District, the
specifications of the CITY and/or the Cupertino Sanitary District shall take precedence over and be
used in lieu of such conflicting portions .
c. Repair and replacement of damaged public facilities. Developer shall, at its own expense,
repair or replace all public improvements, public utility facilities, surveying monuments and other
public facilities that are destroyed or damaged as a result of any work under this agreement.
Developer shall promptly notify the City Engineer of such damage and shall obtain the City
Engineer 's approval of all repair and replacement of damaged facilities.
d . Developer's responsibility until City's acceptance . Until City accepts the Improvements,
Developer shall be responsible for the care and maintenance of such improvements and shall bear
all risks of loss or damage to the improvements. City shall not have any liability for any accident,
loss or damage to the Improvements prior to their completion and acceptance by City. City's
acceptance of the Improvements shall not constitute a waiver of any defects in the Improvements
or Developer's obligation to repair such defects as provided in section 9 of this Agreement.
2. TIME FOR INSTALLATION OF IMPROVEMENTS
a. Required time of completion. DEVELOPER shall install and complete the Improvements
within one (1) year from the date of execution of this AGREEMENT, or such longer period as
may be specifically authorized in writing by the City Engineer. In the event the DEVELOPER
fails or refuses to complete the Work within the specified period of time, the CITY , at its sole
option , shall be authorized to complete the Work in whatever manner the CITY shall decide .
In the event the CITY completes the Work, the CITY may recover any and all costs incurred
thereby from the DEVELOPER or the DEVELOPER'S surety or both. No final inspection shall
Pa ge 2 of 11
be granted or street improvements shall not be accepted unless all the requirements for
safety purposes are installed, such as sidewalks, handicap ramps, street lights, etc.
3. DEDICATION OF EASEMENTS OR RIGHTS OF WAY
No dedication required .
4. QUITCLAIM DEED
DEVELOPER, when requested by the CITY, shall quitclaim all his/her rights and interests in, and
shall grant to CITY authorization to extract water from the underground strata lying beneath said
project. DEVELOPER agrees to execute a "Quitclaim Deed and Authorization" in favor of CITY,
when presented to him/her for signature.
5. SECURITY
a. Required Security. Prior to execution of this Agreement, Developer shall provide the following
security to City in a form acceptable to the City:
(1) Faithful performance. Security for faithful performance in the amount set forth Part A
Exhibit 6, the SCHEDULE OF BONDS, FEES AND DEPOSITS, attached and incorporated by
reference as Exhibit B.
(2) Labor and Materials. Security for labor and materials in the amount set forth Part B of
Exhibit 6, the SCHEDULE OF BONDS, FEES AND DEPOSITS, attached and incorporated by
reference as Exhibit C.
b. Form of Security. Developer shall provide as security, bonds executed by a surety company
authorized to transact a surety business in the State of California and approved by the City as to
sufficiency. In the event that the DEVELOPER shall fail to faithfully perform the covenants and
conditions of this AGREEMENT, or to make any payment, or any dedication of land, or any
improvements herein required, the CITY shall call on the surety to perform this AGREEMENT or
otherwise indemnify the CITY for the DEVELOPER'S failure to do so.
In lieu of a surety bond, the DEVELOPER may elect to secure this AGREEMENT by depositing with
the CITY (1) Cash; (2) A cashier's check, or a certified check payable to the order of the City of
Cupertino; or (3) A certificate of deposit, or instrument of credit acceptable to the City and
meeting the requirements of Government Code Section 66499 (b) or (c). The amount of said cash,
checks, certificate of deposit, or instrument of credit shall be as designated by the City Engineer,
and shall be the equivalent to that which would have been required had the DEVELOPER furnished
the CITY with a faithful performance surety bond. In the event that the DEVELOPER shall fail to
faithfully perform the covenants and conditions of this AGREEMENT, or to make any payment, or
any dedication of land , or any improvements herein required, the CITY may apply the proceeds of
said security thereto.
Page 3 of 11
c. Release of Security. No release of surety bond, cash deposit, check or certificate of deposit shall
be made except upon approval of the Director of Public Works. Schedule for bond and insurance
release for paper bonds are as follows:
(1) Release of 90 percent of the faithful performance bond upon acceptance by the Director of
Public Works .
(2) Release of the remaining 10 percent of the performance bond at one year from acceptance
after all deficiencies have been corrected and in the absence of any claim against such bond.
(3) Release of the entire labor and material bond at six months from acceptance after all
deficiencies have been corrected and in the absence of any claim against such bond .
(4) Liability insurance, provided by the DEVELOPER to hold the CITY harmless in the event of
liability arising from the project, to be retired at the end of one year if all deficiencies have
been corrected and in the absence of any claim against such insurance.
6. PAYMENT OF REQUIRED FEES
a. Permits and licenses. Developer shall, at its sole expense, obtain all necessary permits and
licenses for the construction and installation of the Improvements, give all necessary notices, and
pay all fees required by City ordinance, including but not limited to the fees described in this
Agreement, and all taxes required by law.
b. Fees. Developer shall pay fees in the amounts set forth in Exhibit A, including but not limited to
the following, as required:
(1) Inspection Fees. DEVELOPER shall pay any and all necessary direct expenses for inspection,
checking, etc. incurred by CITY in connection with said Project, and that DEVELOPER shall
have deposited with CITY, prior to execution of this AGREEMENT . Should construction cost
vary materially from the estimate from which said sum is calculated, the City Engineer shall
notify DEVELOPER of any additional sum due and owing as a result thereof.
(2) Storm Drainage Fee. DEVELOPER shall deposit with the CITY, prior to execution of this
AGREEMENT, a storm drainage charge in connection with the said Project in accordance
with the requirements established in Resolution 4422, March 21, 1977.
(3) Map Checking Fee . DEVELOPER shall deposit with CITY, prior to execution of this
AGREEMENT, for office checking of final map and field checking of street monuments, in
compliance with Section 4:1 of Ordinance No. 47 (Revised 12/04/61) of CITY .
(4) Park Fee. DEVELOPER shall pay such fees and/or dedicate such land to the CITY, prior to
execution of this AGREEMENT, as is required within Section 18-1.602, Park Land
Dedication, Cupertino Municipal Code. Park fees are calculated in accordance with action
adopted by the City Council on March 19, 1991 and Chapter 14.05 or Section 18-1.602 of
the Cupertino Municipal Code.
(5) Reimbursement Fee . DEVELOPER shall deposit with the CITY, prior to execution of this
AGREEMENT, a reimbursement fee for any street improvements that have been installed
by the City, or by another property owner. Developer shall pay the City for the cost of the
land at the cost to the City, or another property owner, and shall pay a street improvement
Page 4 of 11
reimbursement charge for the improvements which the City or another property owner,
installed on the street abutting or included in the benefited property, in an amount equal
to the total improvement costs for each particular benefited property as set forth in a
reimbursement agreement. Payments for both land and improvements shall include simple
interest in the amount of seven percent per year, to be calculated in the following manner:
(i) Land Cost. Interest to accrue from the date the street improvements are
accepted by the City to the date the street improvements reimbursement charge is
paid, or if the land is purchased by the City for a City project, from the date of
purchase to the date the charge is paid.
(ii) Improvement Cost. Interest to accrue from the date the street improvements
are accepted by the City to the date the street improvement reimbursement charge
is paid, or if installed by the City, from the date installation commenced to the date
the charge is paid .
(iii) Provided, however, that the interest shall be waived if the adjoining property
owner dedicates or has dedicated to the City land necessary for the street
improvements, or where no such dedication is necessary .
7. DEVELOPMENT MAINTENANCE DEPOSIT
DEVELOPER shall pay to the CITY, prior to execution of this AGREEMENT, the amount set forth in
Exhibit A as a development maintenance deposit. City may use the deposit at its discretion to
correct deficiencies and conditions caused by the DEVELOPER or his/her contractor that may arise
during or after the construction of the development, and to obtain copies of approved plans for
the CITY's files . If the costs exceed the amount deposited, DEVELOPER shall pay actual overage
prior to return of original plans. Any unexpended amount will be returned to the DEVELOPER at
the time all bonds are released in accordance with paragraph 5 of this agreement.
8. STREET TREE INSTALLATION
DEVELOPER shall fund the City for purchase and planting of street trees as deemed appropriate by
the City Engineer; or shall, at the discretion and at such time as deemed appropriate by the City
Engineer, plant street trees in conformance with the standards of the City of Cupertino. The
variety, number and location of trees are subject to City's prior approval.
9. MAINTENANCE AND WARRANTY
a. Developer guarantees and warrants the Improvements and agrees to remedy any defects,
damages, or imperfections in the Improvements arising from faulty or defective materials or
construction of the Improvements for a period of one year after City's acceptance of the
Improvements.
Page 5 of 11
b. If, within the warranty period, the Improvements or any part of the Improvements fail to fulfill
any of the requirements of this Agreement or the Improvement plans and specifications,
Developer shall repair, replace or reconstruct any defective or otherwise unsatisfactory parts of
the Improvements without delay and at no cost to City. If (a) Developer fails to commence repairs
within thirty (30) days of the date of mailed written notice from City, or (b) City determines that
public safety requires repair before Developer can be notified, City may, at its sole option, perform
the required repair itself. Developer agrees to pay the cost of any repairs City performs pursuant
to this agreement and City may, at its option, recover that cost as a lien against Developer's
property.
10. SANITARY DISTRICT
DEVELOPER shall file with the CITY, upon execution of this AGREEMENT, a letter from the
Cupertino Sanitary District stating that the DEVELOPER has submitted plans for review by the
District and that sanitary sewers are available to serve all lots within said Project.
11. GOVERNMENT COSTS
DEVELOPER shall file with the CITY, upon execution of this AGREEMENT, substantial evidence that
all provisions of Section 66493, Article 8, Chapter 4 of the Government Code, pertaining to special
assessments or bonds, have been complied with .
12. UTILITIES
DEVELOPER shall pay to Pacific Gas and Electric Company, AT&T, and/or appropriate utility
companies, any and all fees required for installation of overhead and/or underground wiring
circuits to all electroliers within said property and any and all fees required for undergrounding as
provided in Ordinance No. 331 of CITY when the DEVELOPER is notified by either the City Engineer,
Pacific Gas and Electric Company, AT&T, or appropriate utility companies that said fees are due
and payable.
13. EASEMENTS AND RIGHT-OF-WAY
Developer shall acquire any easement and right-of-way necessary for completion of the Project at
its own cost and expense. However, that in the event eminent domain proceedings are required,
the CITY for the purpose of securing said easement and right-of-way, DEVELOPER shall deposit
with CITY, a sum covering the reasonable market value of the land proposed to be taken and, to be
included in said sum, shall be a reasonable allowance for severance damages, if any. It is further
provided that in addition thereto, such sums as may be required for legal fees and costs,
engineering, and other incidental costs in such reasonable amounts as the CITY may require, shall
be deposited with the City of Cupertino .
P age 6 of 11
14. HOLD HARMLESS AND INDEMNIFICATION
DEVELOPER shall indemnify and hold harmless CITY, its officers, agents and employees from and
against any or all claims, loss, cost, expense, damage or liability, resulting or in any way arising out
of Developer's performance or nonperformance of his/her duties under this Agreement, or from
negligent acts or omissions or willful misconduct of Developer's agents, employees and
contractors, or subcontractors. Developer shall, at his/her own cost and expense, defend any and
all actions, suits or legal proceedings that may be brought against the City, it officers, agents and
employees resulting from or arising out of Developer's performance or nonperformance of his/her
duties and obligations under this agreement, except to the extent any of the foregoing is caused
by the negligence or willful misconduct of the CITY or the CITY'S agents, employees and
independent contractors.
15. INSURANCE
DEVELOPER shall maintain in full force and effect at all times during the term of this Agreement, a
policy of insurance naming the CITY and members of the City Council of the City of Cupertino
individually and collectively, and the officers, agents and employees of the CITY individually and
collectively, as additional insured . Said separate policy shall provide bodily injury and property
damage coverage to the foregoing named CITY and individuals covering all the Work performed
by, for, or on behalf of said DEVELOPER. Both bodily injury and property damage insurance must
be on an occurrence basis; and said policy or policies shall provide that the coverage afforded
thereby shall be primary coverage to the full limit of liability stated in the declarations, and if the
CITY, its members of the City Council individually and collectively, and the officers, agents and
employees of the CITY, individually and collectively, have other insurance against the loss covered
by said policy or policies, that other insurance shall not be called upon to cover a loss under said
additional policy.
The insurance carrier shall be licensed to do business in the state of California and provide proof of
their ratings. All ratings should be Best's Guide Rating of A, Class VII or better or that is acceptable
to the CITY. Each of said policies of insurance shall provide coverage in the following minimum
amounts : for general liability for bodily injury, personal injury and property damage $1,000,000
each occurrence, with an aggregate limit of not less than $2,000,000 .
DEVELOPER shall file with the City Engineer at or prior to the time of execution of this AGREEMENT
by the DEVELOPER evidence of insurance coverage satisfactory to the City. Each policy or policies
shall bear an endorsement precluding the cancellation or reduction in coverage without giving the
City Engineer at least thirty (30) days advance notice thereof.
In the event that the Improvements are situated in or affect the area of jurisdiction of a separate
municipality or political subdivision of the State of California, the required insurance shall also
name the other jurisdiction(s) as additional insured .
P age 7 of 11
16. MAPS AND/OR IMPROVEMENT PLANS
Developer shall provide CITY with the following maps and/or plans at the DEVELOPER'S expense:
A. A mylar blackline and three {3} prints of fully executed parcel map .
B. A mylar blackline and three {3} prints of fully executed improvement plans.
C. A scan in raster format of all executed improvement plans and map .
D. One (1) Yi size prints of fully executed plans and map.
The DEVELOPER agrees to pay the CITY from the development maintenance deposit the cost for all
prints of plans and maps . If costs exceed the amount deposited the DEVELOPER is required to pay
actual overage prior to return of original plans.
17. SUCCESSORS AND ASSIGNS-COVENANT RUNNING WITH THE LAND
This Agreement shall inure to the benefit of, and be b i nding upon the heirs, administrators,
successors, assigns and transferees of the Parties, and shall be recorded in the Office of the County
Recorder and constitute a covenant running with the land . Upon any sale or division of the
Property, the terms, covenants, conditions and restrictions of this agreement shall apply to each
parcel , and the owner or owners of each parcel shall succeed to the obligations imposed upon
developer by this Agreement.
18. FAILURE TO PERFORM
In the event developer fails to perform one or more of the covenants and conditions of this
agreement, City at its option shall have recourse to the security given to guarantee the
performance of such acts . City may, at its option, do or cause to be done, the acts required of
Developer and shall have recourse against as much of the security is necessary to discharge
Developer's responsibility . City shall also have recourse against developer for any and all amounts
necessary to complete the obligations of developer in the event that the security is insufficient to
pay such amounts. All administrative costs, including reasonable attorney's fees incurred by City in
addition to the costs of the improvements shall be proper charges against the security and
Developer.
19. NOTICES
All notices, demands, requests or approvals to be given under this Agreement shall be given in
writing and conclusively shall be deemed served when delivered personally or on the second
busine ss day after the deposit thereof in the United States Mail, postage prepaid, registered or
certified , addressed as hereinafter
provided .
Page 8 of 11
All notices, demands, requests, or approvals from Developer to City shall be addressed to City at :
City of Cupertino
10300 Torre Ave .
Cupertino CA 95014
Attention: Public Works Director
All notices, demands, requests, or approvals from City to Consultant shall be addressed to
Consultant at:
Bay Land Consulting, Land Surveyors/Civil Engineers
PO Box 299
Santa Clara, CA 95050
Attention: Scott Hoffman
20. GOVERNING LAW AND ATTORNEY FEES
This Agreement shall be interpreted under, and enforced by the laws of the State of California
excepting any choice of law rules which may direct the application of laws of another jurisdiction .
The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and
regulations of the authorities having jurisdiction over this Agreement (or the successors of those
authorities.) Any suits brought pursuant to this Agreement shall be filed with the courts of the
County of Santa Clara, State of California.
If City sues to compel Developer's performance of this Agreement, or to recover damages or costs
incurred in completing or maintaining the work on the Improvements, Developer agrees to pay all
attorney's fees and other costs and expenses of litigating incurred by the City, even if Developer
subsequently resumes and completes the work.
21. RELATIONSHIP OF PARTIES
Neither Developer nor any of its contractors, employees or agents shall be deemed to be agents of
the City in connection with the Performance of Developer's obligations under this agreement.
22. SEVERABILITY
The provisions of this Agreement are severable . If any portion of this Agreement is held invalid by
a court of competent jurisdiction, the remainder of the agreement shall remain in full force and
effect.
23. INTEGRATED AGREEMENT
This Agreement represents the full and complete understanding of every kind or nature
whatsoever between the parties hereto, and all preliminary negotiations and agreements of
whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be
held to vary the provisions hereof. Any modification of this Agreement will be effective only by
written execution signed by both City and Developer. All unchecked boxes do not apply to this
Agreement.
Page 9 of 11
IN WITNESS WHEREOF , the Parties have caused this agreement to be executed by their respective,
duly authorized officers on the date listed above.
Approved as to form:
WYl1 \J City Attorney
Attach Notary acknowledgement
Exhibits:
Exhibit A-Schedule of Bonds, Fees and Deposits
Exhibit B -Faithful Performance Bonds
Exhibit C -Labor and Materials Bonds
Page 10 of 11
CITY OF CUPERTINO :
Timm Borden , P.E.
Director of Public Works
DEVELOPER:
Doreen Ravetti
Exhibit A
SCHEDULE OF BONDS, FEES, AND DEPOSITS
Street Improvement Category:
PART A. Faithful Performance Bond :
110-2211 $.00
PART B. Labor and Material Bond:
110-2211 $.00
PART C. Checking and Inspection Fee:
110-4538 $.00
PART D. Development Maintenance Deposit:
110-2211 $.00
PART E. Storm Drainage Fee -Basin 2:
215-4072 $.00
PART E. Storm Drainage Fee -Basin 3 :
215-4073 $.00
PART F. Street Light -One-Year Power Cost:
110-4537 $0.00
PART G. Map Checking Fee:
110-4539 $0.00
PART H. Park Fee -Zone II:
280-4082 $0 .00
PART H. Park Fee -Zone Ill:
280-4083 $0.00
PART I. Reimbursement Fee : $0 .00
Page 11 of 11
j Exhibit 8 I
Annual Premium $~6_0_0_.o_o_~-
Bond # 1120579
FAITHFUL PER.FOR.MANGE AND COMPLET ION ThifPROVE:W1ENT BOND
KNOW ALL MEN BY THESE-PRESENTS:
That we, Doreen Ravetti
as Principal nnd Lexqn insuranc~ Company . __
as Surety are held aud fmnly · bound unto the City @f Cupertmo 1 State of California, in the sum of
Twenty nousand and 00/100 Dollars ($ 20,000.00__) we bind
ourselves, 01.ir heirs, exect1tors, successors, and assigns, jointly and severally, firmly by these presents,
THE CONDITION of the foregoing obligation is such that,
WHEREAS, said Princjpal will perfot:m all necessary improvements relative to
City Sidewalk
toca ted ~ 10110 Peninsula Ave ., Cupertino, CA 95014 in ilCcordance with the approved improvement
plans prepared by . Mark Thomas -----__ _, Civil Engineer on file irt the Engineer's
Office, City of Cupertino, and incorporated herein by referenc e.
'WHEREAS, impro:vemeats shall be -0omplefed within on e (1) year from the date of acceptance of this bond
by the City ,council.
WHEREAS, improvements shalt be maintained for n ,period of nt least one (l) yenr after acceptance of
construction by tho City. This bond shall be in full force and effect thro ugh the period ofmaintenat:1ce as provided in
said contract. The maintenance period shall continue until such tim e that all deficiencies of construction are cm1·ected
to the satisfaction of the City Engineer's Office.
WHEREAS, Principal and S0rt1ty s1mll be re~p onsible for any and all damages arising under the odghiaJ
contract. ·
NOW THEREFORE, if the sald Principal shall well .and tru[y do and pcrfmm all the covenants and
obligations as set fo1 :th above, 0n its part to be ,done and perfonned at the time and in the manner specified th(jruir1,
then this obligation shall bemill and void., otherwise1 this bond S:hall .remain in full force and effect.
In witness whereof, this fostrumen:t has been duly exe@teGI by ihe Principal and Surety this 23rd __ day of
June 20 15 • '--···-
(To be signed by Principal and Surt1ty ..
Notat)'. Acknowkdgementsre uited.)
Doreen Ravetti ~ /) LL-· ·-~-·· .. ~~--"'-.-Princip al
The above bond is accepted and approved this~--day of ______ , 20~·
2/4/00
POWER OF ATTORNEY LX-247195
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS, that LEXON INSURANCE COMPANY, a Texas Corporation, with its prin cipal office in
Louisville, Kentucky, does hereby constitute and appoint: Elizabeth Brooks , Leslie A . Worley. Chetta Ellis. Amy Mendez, Betsye Thomas, Jessi ca
Spears its true and lawful Attorney(s)-ln -Fact to make, execute, seal and deliver for. and on its behalf as surety, any and all bonds , undertakings
or other writings obligatory in nature of a bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directo rs of LEXON INSURANCE
COMPANY on the 1st day of July, 2003 as follows:
Resolved, that the President of the Company is hereby authorized to appoint and empower any representative of the Company or other
person or persons as Attorney-In-Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other
writings obligatory in nature of a bond not to exceed $ 2,500 ,000.00, Two Million Five Hundred Thousand dollars, which the Company might
execute through its duly elected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney-In-Fact
shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any
Attorney-In-Fact, so appointed, may be removed for good cause an d the authority so granted may be revoked as specified in the Power of
Attorney .
Resolved, that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granted,
and the signature of the Assistant Secretary, and the seal of the Company may be affi xed by facsimile to any certificate of any such power and
any su ch power or certificate bearing such facsimile signature and seal shall be val id and binding on the Company. Any such po wer so executed
and sealed and certificate so executed and sealed shall, with respe ct to any bond of undertaking to which it is attached, continue to be valid and
binding on the Company.
IN WITNESS THEREOF, LEXON INSURANCE COMPANY has caused this instrument to be signed by its Presid ent, and its Corporate
Sea l to be affixed this 21 st day of September, 2009.
ACKNOWLEDGEMENT
LEXON INSURANCE COMPANY
BY~~_.,,_~~Da-+-~-id~-E ...... ~~a-m-pb-el...,,,I ...,_~~~
President
On th is 21 st day of September, 2009 , before me , person a ll y cam e David E. Campbell to me known, who be duly sworn, did depose and
say that he is the President of LEXON INSURANCE COMPANY, the corporation described in and which executed the above instrument; that he
executed said instrument on behalf of the corporation by authority of his office under the By-laws of sa id corporation .
AMY L. TAYLOR
Notary Public-Slate of Tenn essee
David son Cou nty
Mv Comm issio n Exoi res 0 1-09-16
CERTIFICATE
I, the undersigned, Assistant Secretary of LEXON INSURANCE COMPANY, A Te xa s Insurance Compan y, DO HEREBY CERTIFY that
the original Power of Attorney of which the fo rgoing is a true an d cor rec t co py , is in full force and effect and has not been revoked and the
resolutions as set forth are now in force.
Signed and Seal at Mount Juliet, Tennessee th is Day of ~\,)O,Q_ , 20J.5_.
"WARNING: Any person who knowingly and with intent to defraud any insurance company or other person , files and application for insurance of claim
containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a
fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties."
!Exhibit C
CITY OF
CUPEf(flNO Bond # 1120577
LABOR AND MATERIAL BOND FOR SUBDJVISION IMPROVEMENTS
RecitaLs
1, The City of Cupertino, California) and Doreen Rovetti ------·----_ ·-
(hereina:ftel' referl'ed to as "Principal'\ have entered tnto an agreement whereby Principal agrees to
install and complete certain designated public improvements, dated June 23 , 20~, and
identified as project/tract no., NIA~ is incorporated by this reference as if set forth in full; and,
2. Pursuant to the agreement, Principa l is required, before oonunenclng performance of the
work, to file a good and sufficient payment bond \Vith the City of Cupertino to secure any claims
brought under Title 15, Division 3} Patt 4 of the Civil Code (commencing with Section 3082).
NOW THEREFORE, th e Principal and the undersigned as corpol'ate surety (hereinafter
refemid to as ''Surety'') their heirs, successors, assigns, excc11tors and administrators, jo'intly and
severally are held bound unto the City of Cupertino and all contractors, subcontractors, labol'ers,
materiafmen and .other persons ,employed in th.e performance of the agl'eement and referred in the
aforementioned Civil Code in the sum of TwenlY. Thousand Dollars and, __ 0 .... 0-'-/ .... 1 o"'"o'---~---
dollars ($. 20,000.00 ), for materials fumished or labor thereon of any kind, or for amounts due under
the Unemployment Insurance Act with respect to such work or labor, that the surety will pay the same
in an amount Rot exceeding the amount hereinabove set fo r th, and also in case suit is brought upon this
· bond , will. pay, in addition to the face amount thereof, costs and reasonable expenses and fees,
including reasonable .attorney's fees, incurred by the City ofCuperti1J.o In. successfully enforcing such
obligation, to be awarded and .fixed by the court, and to be taxed as costs and to be included in the
judgement therein rendered.
. It is hereby oxpressly stipulate d and agreed that this bond shall inure to the benefit of any and
alf persons> companies and corporations .entitled to file claJms undet Title 15 (~ommencing with
Sectim1 3082) of Part 4 of Division 3 of the Civil Code , so as to give a right o:f action to them or their
assigns in any .suit brought upon this bond .
Should the condition of this bond be fully performed, then thi s obligat ion sball become null and
void, othmwise, it shall he and remain in foll force and effect.
The surety hereby stipulated and agrees that no change, extensio1i of timeJ alteration or addition
to the tel'ms of said agt-eement or the specifications accompanying the sa me shall, in any manner, affect
its obligations on this bond, and it does hereby waive notiGe .o f any sucb change, extens ion, Blteration
or addition.
2/4/00
IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and Surety
this 23rd day of. June , 20 JL,
{To be signed by Principa-1 and Sul'ety.
Notary Acknowledgements required.)
Doreen Rovetti
Principal
;J(/. ,;{} LL .
By:~~~-~--
Lexon Insurance Co,:ripariy
The above bond is hereby accepted and apptoved this ___ day of ~-_,20_._.
CITY OF CUPERTil-.JO
By:_·=,.,---------~----
2/4/00
POWER OF ATTORNEY LX-247194
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS, that LEXON INSURANCE COMPANY, a Te xas Corporation, with its principal office in
Louisville , Kentucky, does hereby constitute and appoint: Elizabeth Brooks, Leslie A. Worley, Chetta Ellis, Amy Mendez, Betsye Thomas. Jessica
Spears its true and lawful Attorney(s)-ln-Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings
or other writings obligatory in nature of a bond .
This au thority is made under and by th e author ity of a resolution whi ch was passed by the Boa rd of Directors of LEXON INSURANCE
COMPANY on the 1st day of July, 2003 as follows :
Resolved, that the President of the Company is hereby authorized to appoint and empower any representative of the Company or other
person or persons as Attorney-In-Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other
writings obligatory in nature of a bond not to exceed $ 2,500,000.00 , Two Million Five Hundred Thousand dollars, which the Company might
execute through its duly elected officers, and affi x the seal of the Company thereto. Any said execution of such documents by an Attorney-In-Fact
shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company . Any
Attorney-In-Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of
Attorney.
Resolved, that the signature of the President and the seal of the Comp any may be affi xed by facsimile on any power of attorney granted,
and the signature of the Assistant Secretary , and the seal of the Company may be affixed by facsimile to any cert ificate of any such power and
any such power or certificate bearing such fa csimile signature and seal shall be valid and bind ing on the Company. Any such power so executed
and sealed and certificate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and
binding on the Company .
IN WITNESS THEREOF , LEXON INSURANCE COMPANY has caus ed thi s instrument to be signed by its President, and its Corporate
Seal to be affi xe d this 21 51 day of September, 2009.
LEXON INSURANCE COMPANY
BY~~---'<-~~Da-+~-id~-E ........ ~~a-~-pb-el.....,I --~~~
President
ACKNOWLEDGEMENT
On this 21 st day of September, 2009, before me, personally came Dav id E. Campbell to me known , who be duly sworn , did depose and
say that he is the President of LEXON INSURANCE COMPANY, the corporation described in and which executed the above instrument; that he
executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation .
AMY L. TAYLOR
Notary Pub li c-State of Tennessee
David son Cou nty
Mv Commission Exolres 0 1-09-1 6
BY______,.~~ .. ~Am-;-. t ·-+-+-~,~~~--H~'--~~
~fyPublic
CERTIFICATE
I, the undersigned, Assistant Secretary of LEXON INSURANCE COMPANY, A Te xas Insu rance Company, DO HEREBY CERTIFY that
the origin a l Power of Attorn ey of which the forgoing is a true a nd co rrect copy, is in full fo rce and effect and has not be en revoked and th e
resolutions as set forth are now in force.
Signed and Seal at Mount Juliet, Tennessee this Q3r;) Day of ~W (!_ , 20 16 .
h'.d' ) "
BY~~--a·~~··~·-··_·_·· .. _·_._._·~~~---~~---~~:-··~··~-"~~~
Andrew Smith
Ass istant Secretary
"WARNING: Any person who knowingly and with intent to defraud any insurance company or other pe rson, files and application fo r Insurance of claim
containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a
fraudulent insurance act, which is a cri me and subjects such person to criminal and civil penalties."
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of S-ct ., b C l <t.. '"'
before me , f(1,__;-/-<... fZ.e"' e.e Sr va_rc.1 c;,,c AJa fv '1 f cl*> /r'c
(insert name and title of the officer)
personally appeared /) I) ,e e,,., I!. 0 t/<2._ ff-,·
who proved to me on the basis of satisfactory evidence to be the person (.sj whose name {.81 is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/~/their authorized capacity(~). and that by his/her/their signatu ~ on the instrument the
person (,$), or the entity upon behalf of which the person (,aj acted , executed the instrument.
I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature p ~~(Seal)
a KIRSTEN RENEE SOUARCIA
Commission # 2080884
~ Notary Public -Ca li fornia !
z Santa Clara Cou nty -t ;~ .. ,MJ 8°JT ·lfeicrs.a2 1:'1i1il
CALIFORNIA ALL -PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity
of the indiv idual who signed the document to which this certificate is attached ,
and not the truthfulness , accuracy, or validity of that document.
State of California }
County of S:c~ LllL7../lo_ }
On ~ ·3
1
, ;hl, 1-before me , , Ju L-1 A tl ,N S 7 ~o-h-f'..1v Oi L-W, ·,.,
----'~--=-----+--'"----'---(Here insert name and t1t 1e OT tne on,cer)u
personally appeared U 1/'v\., vU-h:kvd ,e,1
who proved to me on the basis of satisfactory evidence to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized capac ity(ies), and that by
his/her/their signature(s) on the inst rument the person(s), o r the entity upon behalf of
which the pe rson(s) acted , executed the instrumen t.
I cert ify under PENAL TY O F PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS my hand and official seal. ·le JULIA KINST Notary Public • C1tlfornla 1
• Santa Clara County
Comm1111on ti 2177456 j
, lb COMIII. hal,n ,ill 25. 2021
Notary ft>.iii bl ic Signa t u re (No tary Pu bli c Seal)
y y
INSTRUCTIONS FOR COMPLETING THIS FORM
ADDITIONAL OPTIONAL INFORMATION This form complies ivith current California statutes regardingnotmy wording and,
DE SC RIPTI ON OF THE ATTACHED DOC UMENT if nee ded, should be comple ted and attached to th e document. Acknowledgments
:z:::t) c_J_, • . .J-. ·"· A ~ from oth er stai es may be co mpleted for do c um ents being sent to that state so long
· -'I ":ll ~t I.{}~~ as the wo rding do es 1101 req uire th e Ca lifornia notw y to vio la te California notW)'
ID It D Vdl-t~ o.i.rf-law .
(fiUe or description of att ached document) • State and Co unty infonnation mu st be th e State and County where the doc um ent
It{) f'( -g W -t) ?·J s igner(s) personall y appeared before th e notary public for ac knowl edgment. ·£0 -~ • Date ofnota,i za tion mu st be th e date th at th e sign er(s) persona ll y appeared wh ich
(Title or description of attached document continued) must also be th e same date th e acknowledgment is completed.
Nu mb er of Pa ge s _Lia Documen t Date l/. 3 -1 ±
CAPACITY CLAIMED BY THE SIGNER
rt Individual (s )
D Corporat e Offic er
(Title )
D Partner(s)
D Attorn ey-i n-Fact
o T ruste e(s)
o Ot her ----------
2015 Version www NotaryClasses com 800-873-9865
• The nota,y publi c mu st p1int hi s or her name as it appears within hi s or her
co mmi ss io n fo ll owed by a comma and th en yo ur titl e (notary publi c).
• Print the nam e(s) of document signer(s) who personally appear at th e tim e of
notatization.
• Indi ca te the conect singular or plura l fonn s by crossing off inconect fonns (i.e .
he/she/they, is /are) or circ ling the con ec t fonns. Failure to conectly indi ca te th is
infonnation may lead to rej ection of document recording.
• The no tary sea l impress ion mu st be cl ea r and photogra phjcally re produc ibl e.
Impress io n mu st not cover tex t or lin es. If sea l impress ion smudges, re-sea l if a
sufficient area pennits, oth erw ise comp lete a di ffere nt ac kn owledgment fo nn .
• Signature of th e notaty public mu st match th e s igna ture on file with the office of
th e co unty clerk .
•!• Additi o nal infonnatio n is no t req uired but co uld help to ensure thi s
ackn owledgm ent is not mi suse d o r attached to a different docum ent.
•!• Indi cate titl e or type of attached document, number of pages and dale .
•!• Indi cate th e ca pacity claimed by th e s igner. If the c laimed capacity is a
coqiorate officer, indi cate th e titl e (i.e. CEO, CFO, Secretary).
• Securely a ttac h thi s do c um ent to th e s ig ned docum ent wit h a sta ple .